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Preparing Teens to Manage Their Healthcare



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In a year or two, your teen will take the leap into the adult world by either going to college or starting full-time work. Now is the time to prepare him for those responsibilities.

For young people with an ADHD diagnosis, that includes becoming responsible for their own healthcare and treatment management. You likely manage doctor appointments, transportation to medical offices, and prescription refills at this point in your child’s life, but very soon he will have to see to these tasks on his own. Your new role in his development is helping him become ready to independently manage these aspects of his own care.

Preparing for adulthood with ADHD

Young people and teens need information to help them understand ADHD. Younger children don’t yet have the maturity to make their own medical decisions, but their thoughts should be taken into consideration. They should be included as much as they are ready to be in those conversations.

Preteens start seeking more independence, needing more privacy, and are better able to explain what they are thinking and feeling. During those years they can begin to have input into their ADHD treatment plans and more actively participate in their behavior management. Very often they want more information about ADHD and the reasons for your decisions on treatment approaches. They may agree with those approaches or they may begin to express a desire to change them. Depending on your child’s maturity level, you might include him in academic meetings with his teachers.

By high school, your teen is ready to start participating more actively in his ADHD management and medical decisions. As his parent or caregiver, you continue to have final say on all medical decisions, but his agreement is necessary for most treatment approaches. This is the time to have him begin asking his doctor for more information. Most doctors will ask parents to step out during medical exams at this point for reasons of privacy, to give teens the opportunity to talk about topics they might be shy about discussing in front of parents.

You can help your teen prepare by role-playing discussions he might have with the doctor. At this age he should know:
  • Any medical conditions and diagnoses he has
  • Any medications, supplements, vitamins, and herbs that he is taking and whether they are part of his ADHD management plan or for general well-being
  • Family medical histories, including whether either of his parents or any of his grandparents have medical conditions that could be inherited
  • Your family’s values and expectations regarding dating, sexual activity, and drug use, including tobacco and alcohol use. The doctor will ask him about these topics, and you should encourage your child to discuss them honestly with the doctor, especially if he’s not ready to discuss them directly with you.

At the beginning, you may want to role play with your teen how to call the doctor’s office, giving suggestions on what to say. The first few phone calls may require you to stay in the room while your teen makes his appointments. The same is true when making arrangements for prescriptions. You may also need to follow-up with your teen to make sure all needed steps are completed.

As your teen progresses in these skills, you will want to move further away. You won’t need to be present when he calls the doctor’s office or the pharmacy. You might not need to drive him to appointments. You might decide to ask at the end of the day how these tasks went for your teen and let him tell you about his success.

Taking on responsibility

When should your teen take on more responsibility? It depends both on his maturity level and whether he has successfully practiced the needed life skills on his own while you are still available to assist when needed. For most teens, this will be during their junior or senior year of high school.

“It is important that teens practice scheduling their own appointments, a surprisingly challenging exercise for today's teens since they do not often use a phone for conversation,” Rock Point School nurse Alison Cannon, CRNP, tells parents. “Teens at this stage should be signing themselves in and going into exams on their own (again, parents can request to be called into the room at the end of the appointment to hear the summary), but, when they are almost eighteen, it may be better to let the teen give you the summary themselves. The more practice our teens get while they are with us, the better prepared they will be to advocate for themselves in the provider's office, and the more empowered they will feel to have a strong voice when faced with difficult health care decisions.”

During the last two years of high school, teens should begin to:
  • Talk with their medical provider about their health, including treatment options for ADHD.
  • Make appointments by telephone for check-ups and when they are not feeling well.
  • Make arrangements for transportation, either by asking parents or family members to drive them, driving themselves, or working out other transportation. Parents may want to continue to approve these travel arrangements.
  • Be able to fill out general medical forms. Teens younger than 18 will likely still need a parent or guardian’s signature to complete the information.
  • Arrange to have prescriptions filled or refilled. Some medications will require an adult’s signature at pickup, but teens should be encouraged to complete the other steps and to pick up any medications that are age-appropriate for them to purchase.
  • Know how to care for their medications. It’s important to discuss with your teen how to prevent diversion of their medications.

“When kids are comfortable and familiar with managing their own meds, including calling the pharmacy or their therapist to ask for a refill, they’re much more skillful and likely to maintain good practices when they get to college,” says Alison Baker, MD.

By their senior year, teens also should know:
  • How insurance works and when to present their insurance cards. You and your teen will want to decide at what age he should start carrying this information with him--often when a teen gets his driver’s license.
  • What it means to get a referral to another doctor and how to ask for one.
  • When and why their parents would be contacted for medical emergencies, including mental health emergencies.
  • Their own healthcare beliefs as well as their family’s values, because their beliefs and values will be the foundation of their self-advocacy.

Many teens will question their ADHD treatment plan. Some will opt to stop taking medication and some will deny that they have ADHD altogether. Other teens will continue with their treatment. All teens should be encouraged to understand their treatment options. As part of the hand-off from teenager to young adult, parents, teens, and their treatment providers should meet together to discuss how ADHD affects the teen and what treatment options are best.

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This article appeared in ADHD Weekly on August 09, 2018.
     


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